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Introduction Student centric learning approaches have been reported to be effective in introducing higher order cognitive skills required by the health professionals. However, learners’ perceptions must be constructively aligned with new learning interventions to achieve a positive impact on their learning. The aim of this study was to explore the learning experiences of undergraduate dental students with case-based learning in orthodontics. Methods A case-based learning model was introduced on orthodontic diagnosis and treatment planning for final year students on a Bachelor of Dentistry programme toward the end of their academic year. A survey was conducted to explore the perceptions and experiences of the participants. The research instrument was based on a previously validated questionnaire and included information on demographics and consisted of 12 items aimed at evaluating the benefits and challenges of cased based learning. Results All 67 students in the final-year cohort participated in study, yielding a response rate of 100 percent. Participants across the board perceived CBL to be an effective strategy to learn the subject content and helpful in improving the students’ skills in orthodontic diagnosis, treatment planning and team-working. CBL did not pose any significant challenges or barriers to student learning. Conclusion Participants reported high acceptance of CBL in orthodontic teaching and learning and a positive impact on their educational experiences. CBL was perceived to be an appropriate strategy to enhance the diagnostic, treatment planning and team-working skills of dental students.

Background Stroke represents a major source of mortality and morbidity globally. The role of a stroke Clinical Nurse Specialist (CNS) as an expert team member in early supported discharge (ESD) for stroke, is not well defined or described although it is well established in other models of after-hospital and out-reach specialist care in the community. A greater focus has been on patients receiving rehabilitation post-stroke, however there is a need for a more holistic approach to care which clinical nurse specialists can offer to patients as part of ESD. Nurses are often the cohesive point of contact for other after-hospital services, managing many aspects of secondary prevention. Objective The aim of this scoping review is to explore the evidence in relation to the role of the stroke nurse providing secondary prevention interventions to stroke patients in a community setting. Methods We will conduct a scoping review in accordance with the Arksey and O’Malley, 2005 1 scoping review framework and the PRISMA-ScR guidelines to map available literature on the role of the stroke nurse in post-stroke care of patients in the community. The Cochrane Central Register of Controlled Trials and Systematic literature searches including databases MEDLINE, EMBASE, CINAHL, google scholar and grey literature will be searched using keyword searches. Data will be charted and synthesised and a narrative synthesis will be conducted. Conclusions This scoping review will be used to identify gaps in the current literature and identify areas for future research in the role of the stroke nurse in ESD in relation to secondary prevention for stroke patients and inform the development of a pathway for stroke nursing in ESD.

The utilization of zein and gum arabic has grown in an attempt to formulate wall materials based on protein–polysaccharide complexes. This mixture provides a versatile delivery system for hydrophilic (guava leaf extract, GLE) or lipophilic (fish oil, FO) bioactive compounds, and it can be used as an edible film-forming polymer. This study was undertaken to characterize FO-containing edible films that were double-layered with a film containing GLE. Modified zein and gum arabic solutions (MG complex) were mixed at a ratio of 1:1.5 (v/v), adjusted to pH 5, added with glycerol (20% of the complex) and FO (5% of the complex), and finally adjusted to pH 5. This was prepared as the bottom/lower layer. The upper/active layer was prepared by mixing MG complex, glycerol, and GLE (1, 3, and 5% w/v of the complex). The total phenolic and flavonoid contents in GLE were 15.81 mg GAE/g extract and 6.99 mg QE/g extract, respectively. The IC50 of the DPPH radical scavenging activity of GLE was 26.86 ppm with antibacterial activity against Bacillus subtilis and Escherichia coli of 9.83 and 12.55 mm. The total plate counts of double-layered films containing GLE were retained below 3 log CFU/g during 28-day storage. The peroxide values of these films were dimmed for no more than 9.08 meq/kg sample on day 28 of storage. Thickness (872.00-971.67 μm), water vapor transmission rate (12.99-17.04 g/m2/day), tensile strength (1.56-2.02 kPa), elongation at break (61.53-75.41%), glass transition (52.74-57.50°C), melting peak (131.59-142.35°C), inhibition against B. subtilis (33.67-40.58 mm), and inhibition against E. coli (2.05-9.04 mm) were obtained by double-layered films. GLE can be successfully incorporated into the active layer of a double-layer film to improve its characteristics while significantly slowing down the microbial contamination and oxidation rate. MG complex and FO can also contribute to the performance of the edible film.

Background The present contribution reexamines the geometry of a segment of a presumably long-lived fault in Svalbard, the Balliolbreen Fault segment of the Billefjorden Fault Zone, along which presumably two basement terranes of Svalbard accreted in the early–mid Paleozoic after thousands of kilometers strike-slip displacement. Methods We performed structural fieldwork to Billefjorden in central Spitsbergen and interpreted satellite images. Results Field observations demonstrate that the Balliolbreen Fault formed as a top-west thrust fault in the early Cenozoic and that weak sedimentary units such as shales of the Lower Devonian Wood Bay Formation and coals of the uppermost Devonian–Mississippian Billefjorden Group partitioned deformation, resulting in significant contrast in deformation intensity between stratigraphic units. For example, tight early Cenozoic folds are localized in shales of the Wood Bay Formation and contemporaneous top-west brittle–ductile thrusts within coals of the Billefjorden Group, whereas Pennsylvanian deposits of the Hultberget (and/or Ebbadalen?) Formation are simply folded into gentle open folds. Rheological contrasts also resulted in the development of décollements locally, e.g., between tightly folded strata of the Wood Bay Formation and Billefjorden Group and flat-lying, brecciated limestone-dominated strata of the Wordiekammen Formation. Despite the limited quality and continuity of outcrops in the area, the eastward-thickening character (i.e., away from the fault) of Pennsylvanian deposits of the Hultberget, Ebbadalen, and Minkinfjellet formations suggests that the fault did not act as a normal fault in Pennsylvanian times. Conclusions The study suggests that strain partitioning of early Cenozoic Eurekan contraction alone may explain the deformation patterns in Paleozoic rock units in central Spitsbergen, i.e., that Late Devonian Svalbardian contraction is not required, and that a major segment of the Billefjorden Fault Zone formed in the early Cenozoic. The present work illustrates the crucial need for interdisciplinary approaches and composite educational backgrounds in science.

People with injuries to the peripheral nervous system suffer from paralysis of the facial muscles, fingers and hands or toes and feet, often for the rest of their lives, due to its poor functional regeneration. Therefore, to improve patients’ quality of life, there is an urgent need for conduits that effectively support the healing of large defects in nerve pathways through specific guidance of nerve cells. This paper describes two specific methods for achieving directed growth of Schwann cells, a type of glial cells that can support the regeneration of the nerve pathway by guiding the neuronal axons in the direction of their alignment. One method uses aligned polyamide-6 (PA-6) nanofibers produced via electrospinning on a very fast rotating structured collector, which enables easy nanofiber detachment, without additional effort. The other method implies the exposure of a poly(ethylene terephthalate) (PET) foil to a KrF* laser beam, that renders a nanorippled surface topography. Schwann cell growth on these substrates was inspected after one week of cultivation by means of scanning electron microscopy (SEM). For both methods we show that Schwann cells grow in a certain direction, predetermined by nanofiber and nanoripple orientation. In contrast, cells cultivated on randomly oriented nanofibers or unstructured surfaces, show an omnidirectional growth behavior. These two methods can be used to produce nerve conduits for the treatment of injuries to the peripheral nervous system.

Background Auditors during COVID-19 experienced an unprecedented situation, in which normal audit activities were difficult to conduct. Moreover, COVID-19 forced auditors to introduce a new audit approach, “remote auditing,” which was not common in most audit firms and required the adoption of more advanced technologies. Overall, auditors during the COVID-19 pandemic needed both cognitive and technical factors to deliver high-quality audits. Despite these challenges, research on how auditors deal with these issues is limited, presenting an intriguing area of study. Methods This dataset provides insights into Saudi auditors’ experience and beliefs regarding audit activities during COVID-19. Through an online survey, researchers collected data from 193 of 417 registered auditors with the Saudi Organization for Chartered and Professional Accountants (SOCPA). The survey assessed auditors’ self-efficacy in conducting audits during the pandemic and explored its sources and potential moderating factors. Specifically, the dataset includes responses to eight items related to self-efficacy, 19 items covering four common sources of self-efficacy (mastery experience, vicarious experience, social persuasion, and physiological/emotional states), and six items assessing virtual audit competency. Additionally, the dataset contains demographic information that is valuable for researchers analyzing the relationship between auditor self-efficacy, its sources, and other influencing factors. Conclusions Overall, the dataset included in this study may serve a broader audience and be useful in improving several stakeholders’ understanding of the effects of COVID-19 on auditors and how auditors assess their ability to adapt to COVID-19 consequences. This study contributes to the existing body of knowledge by highlighting the need for auditors to adapt to new circumstances and adopt innovative approaches during challenging times, thereby ensuring the delivery of high-quality audits.

Biopesticides are pest control products derived from natural sources such as microbes, macro-organisms (insects and pathogens), plant extracts, and certain minerals. Many biopesticides are considered environmentally safe and can complement or substitute conventional chemical pesticides. They can also be highly specific or broad spectrum with a unique mode of action controlling a wide range of pest species. Due to their target-specificity and low to no environmental residuality, biopesticides conform to the 3 pillars of Climate-Smart Agriculture, the Sustainable Development Goals, and, ultimately, the Paris Agreement. This review focuses largely on microbial biopesticides derived from fungi, bacteria, viruses, and nematodes. It discusses (i) the various microbial biopesticide formulations, (ii) the mode of microbial biopesticide action, (iii) the factors that affect the potential efficacy of biopesticides, (iv) challenges to the adoption of microbial biopesticides, and (v) the role of microbial biopesticides in Integrated Pest Management programs. Finally, advancements in application techniques, as well as future research directions and gaps, are highlighted.

Background Over the past few decades, World Health Organization (WHO) has made massive efforts to promote the development of a vaccine against Lassa virus (LASV), one of the top ten priority pathogens for research and development under the WHO R&D Blueprint for Emerging Infections. To date, several vaccines are at different stages of development. In this scenario, a validated and standardised assay to measure LASV neutralising antibodies is urgently needed for vaccine development and comparison. Methods The neutralisation assay remains the gold standard for determining antibody efficacy. Here we have proposed a safe and validated pseudotyped neutralisation assay for LASV, taking advantage of the development of the first WHO International Standard and Reference Panel for Anti-Lassa Fever (NIBSC code 21/332). Results and Conclusions The proposed results demonstrate that the pseudotyped luciferase neutralisation assay is a specific serological test for the measurement of LASV neutralising antibodies without cross-reacting with standard sera specific for heterologous viral infections. In addition, the assay is accurate, precise, and linear according to criteria and statistical analyses defined and accepted by international guidelines.

Introduction Surgical removal of an impacted third molar is one of the most common oral surgical procedures performed in dental offices. The postoperative phase is often associated with severe inflammation. Non-steroidal anti-inflammatory drugs (NSAIDs) are usually prescribed to manage postoperative discomfort. NSAIDs have been associated with gastrointestinal bleeding, renal function disturbances, and platelet count reductions. Thus, the present study demonstrates the utility of aescin in managing postoperative discomfort after the surgical removal of impacted mandibular third molars. This study aimed to correlate and compare the impact of aescin and diclofenac on salivary PGE2 levels and serum C-reactive protein levels after surgical extraction of the mandibular third molar. The study will also evaluate and compare the effectiveness of individual drug therapy in managing postoperative pain, swelling and mouth opening. Methods The planned study is a single-center, double-blind, randomized, parallel, prospective clinical trial. Each patient will be prescribed either diclofenac sodium 150 mg/day or aescin (escin) 120 mg/day to be taken orally in divided doses for five days after surgically removing the impacted mandibular third molar. Pain will be assessed using a visual analog scale. Facial swelling and mouth opening will be recorded using a metric scale with standardized reference points. ELISA (enzyme-linked immunosorbent assay (ELISA) will be employed to measure salivary Prostaglandin E2 and serum C–reactive protein levels. All parameters will be recorded preoperatively (T0) on the second postoperative day (T1) and fifth postoperative day (T2). Conclusion The proposed study is expected to show a clinically acceptable response to the administration of aescin for the management of postoperative discomfort compared to diclofenac sodium after third molar surgery. The proposed study is expected to positively manipulate the levels of salivary Prostaglandin E2 and serum C–reactive protein, which are reliable inflammatory markers. The outcome of this study may provide an efficacious and safe alternative to conventional nonsteroidal anti-inflammatory drugs for managing postoperative discomfort following third molar surgery.

Our current global Food System is facing extraordinary challenges in both size and severity, including a rise in unsustainable consumption behaviours, continued environmental degradation, growing food insecurity, and widening social inequalities. A Food System transformation is now both critically important and overwhelmingly complex, requiring nothing less than a complete overhaul of the entire value chain. Everyone is needed: Small Medium Enterprises (SMEs) with technological solutions, Non-Governmental Organisations (NGOs) with social innovations, researchers with novel methodologies, governments with food policy advancements, professionals with varying expertise, and last but not least, empowered and informed citizens with the ability and resources for better decision-making. Living Labs offer a holistic, place-based approach needed to facilitate multi-actor inputs on various levels, specifically Food System Living Labs (FSLLs) like the ones established as part of the FoodSHIFT 2030 Project. Nine front-runner Food System Living Labs were operationalised alongside a novel framework merging high-level interdisciplinary initiatives with a diverse set of innovative approaches towards more Sustainable Food Systems (SFS). The FoodSHIFT Approach concept was praised by external evaluators for its ground-breaking framework, and the nearly completed project has been listed as a best practice. However, positive applications alone will not ensure a cross-sector European-wide Food System transformation, and the following text offers a critical reflection coupled with experience-based solutions to further improve the FoodSHIFT Approach.

Introduction In Syria, specialist dentists undergo five years of undergraduate education and four years of postgraduate education. In the latter, students engage in treating complex cases as part of their professional training. This study aimed to obtain in-depth qualitative understanding of the clinical learning environment at Damascus University Faculty of Dental Medicine, Syria. Methods Semi-structured interviews were held with eight postgraduate dental students at Damascus University Faculty of Dental Medicine. The faculty has eight clinical departments; therefore, a single participant was purposively sampled from each department. The male-female ratio of the eight interviewed participants was 1:1. All interviews were conducted between 26th April 2020 and 8th January 2021. Data were analyzed inductively using reflective thematic analysis. Pragmatic saturation was discussed during the analysis and the authors made an interpretative judgement to stop data collection at the eighth interview. Results Major themes which emerged covered different aspects of the clinical learning environment such as clinical training, social interaction and assessment procedures. Faculty’s negligence of their teaching duties was one of the most recurrent themes. In clinical training and due to faculty inaccessibility, students had to rely on themselves or their senior peers in training. The social climate was perceived negatively and assessment was described as unfair and biased. Discussion The findings of this study were framed within Gruppen et al. (2019) theory of the learning environment wherein four dimensions emerge: the personal, the social, the organizational and the material. The findings of this study showcased the continuing deterioration of the clinical learning environment at Damascus University. It is hoped that these findings will encourage decision makers to introduce a comprehensive reform that addresses the curriculum, teaching practices and assessment procedures in clinical professional training.

Text and data mining (TDM) is a process, typically automated, that looks for patterns in data that may otherwise remain unnoticed. In a world where data driven solutions play a progressively more important role, TDM has become a vital tool in sectors ranging from medicine, to commerce, gaining widespread attraction. Nevertheless, a variety of regulatory frameworks not always specifically attuned towards regulating TDM continue to apply concurrently. The literature within the context of regulatory frameworks governing TDM is a fragmented piecemeal of valuable insights into what “lawful” TDM resembles. This literature review adopts a grounded theory approach analysing 88 pieces of literature, collating views regarding “lawful” TDM, ultimately providing a holistic assessment of academics’ and practitioners’ views and opinions regarding the regulatory framework which governs TDM. A total of 7 categories were identified and each of these are analysed. Tables are provided in the Appendix (accessible here: https://doi.org/10.5281/zenodo.12654691)highlighting which scholarly works were used for each section of the literature review, but also how those works were used. It is ultimately concluded that the regulatory frameworks that apply to users conducting TDM are multifaceted, and ever-changing on a case-by-case basis. There is an ever-growing need for a holistic interpretation of the regulatory frameworks which apply, creating a map which would allow for users conducting TDM to navigate this complex web of legal rules.

The metaverse is based on immersive technologies such as virtual and augmented reality, body tracking, tactile sensation, etc. A growing number of studies are demonstrating the potential of the metaverse as an attractive resource for learning medicine. However, in practice, medical teachers and students often encounter significant challenges when utilizing the underlying technologies, potentially leading to frustrating learning experiences. A significant part of the teaching time is often devoted to troubleshooting technical issues with the metaverse, and the medical content itself taking a backseat until students become proficient in navigating the metaverse environment. Therefore, it is essential to fit the metaverse's underlying technologies specifically for medical education, minimizing technical hurdles for both teachers and students. In this paper, we deal with this challenge and we present a collection of practical tips that serves as a guide for medical educators making decisions in this emerging field, where they may lack prior experience. Drawing on our observation with a cohort of 776 medical students, we conclude how to effectively identify, design, or implement educational applications tailored for efficient medical learning through the metaverse. Our work may support teachers considering metaverse learning platforms for their classrooms and it is a beneficial reference for the medical education community during the initial stages of implementing the metaverse for teaching.

Background HIV pre-exposure prophylaxis (PrEP) is a medication that prevents the acquisition of HIV, most commonly taken in the form of a pill. PrEP is an efficacious tool for HIV prevention, including among gay, bisexual, and other men who have sex with men (gbMSM). PrEP is often provided through formal PrEP programmes. Research on these programmes may employ discourses shaped by heteronormativity and homophobia. Given that expert language influences how HIV prevention is understood and delivered, problematic discourses in research likely extend into PrEP implementation. This study will use critical discourse analysis (CDA) to explore research on PrEP programme implementation for gbMSM. Within this literature, we will identify interpretive repertoires used to discuss gbMSM; the subject positions afforded to gbMSM; and the implications of these interpretive repertoires and subject positions for gbMSM engaging with HIV PrEP programmes. Methods Systematic search methods identified relevant articles through timebound searching (2012–2023) in ProQuest ASSIA, EBSCOhost PsycInfo, OVID Medline, OVID Embase, and EBSCOhost CINAHL, with forward and backward citation searching of included studies. Grey literature will be identified through ProQuest and Google Scholar. Screening will be conducted by two independent reviewers, who will conduct random partial double screening for titles and abstracts and for all full text articles. Data will be analysed and synthesised using CDA informed by critical realism (CR). CDA focuses on relationships between language and power, including how language enables inequality. The analytic process will explore the background of included studies, identify themes, and analyse external and internal relations in included studies. Conclusions Highlighting issues with discourses in PrEP implementation may enhance reflective engagement with assumptions underlying this research, preventing further stigmatisation of gbMSM’s sexual and protective practices. As PrEP programmes become more common, diverse and inclusive perspectives in PrEP programme research may inform interventions that enhance their acceptability and implementation.

Background Acute coronary syndrome (ACS) remains one of the leading causes of death worldwide. Smoking may also increase the risk of developing ACS. The most advantageous therapy is percutaneous coronary intervention. However, this therapy may fail because of the no-reflow phenomenon. This case report describes a young male patient admitted to the emergency department due to ST-segment elevation of myocardial infarction (STEMI), with smoking as the only risk factor. Case description A 37-year-old male presented to our hospital with a typical chest pain. He was a heavy smoker. Electrocardiography (ECG) revealed extensive anterior STEMI. Coronary angiography revealed total occlusion of the proximal left anterior descending artery (LAD) with a high-burden thrombus. The no-reflow phenomenon occurs during Percutaneous Coronary intervention (PCI). After two days of hospitalization, the patient developed cardiogenic shock and acute decompensated heart failure. The patient was administered ticagrelor, acetylsalicylic acid, enoxaparin for three days, high-dose statins, and optimized heart failure treatment. The patient was discharged on the 7th day after admission. Discussion Cigarette smoke chemicals may induce atherosclerosis and thickened blood in the arteries. Lipid oxidation leads to plaque formation. If plaque ruptures, it will cause thrombus occlusion. A high-burden thrombus can induce a no-reflow phenomenon, leading to heart failure and cardiogenic shock. Conclusion Smoking may induce STEMI and tends to result in a high-burden thrombus. The no-reflow phenomenon is an evidence of miscarriage during PCI, which may increase because of smoking.

Background Agent-based modelling provides an appealing methodological choice for simulating human behaviour and decisions. The currently dominant approaches based on static transition rates or unverified assumptions are restrictive, and could be enhanced with insights from cognitive experiments on actual decision making. Here, one common concern is that standard surveys or experiments may lack ecological validity, limiting the extent to which research findings can be generalised to real-life settings. For complex, highly emotive decision-making scenarios, such as those related to irregular migration, the typically used short, methodical survey questions may not appropriately map onto complex real-world decisions of interest. Immersive contexts may offer more accurate representations of reality, potentially enhancing the usefulness of experimental information in multi-disciplinary modelling endeavours. Methods This preregistered study, aimed directly at examining the effect of immersion on risk-taking in the context of migration decisions, and indirectly at informing a multi-disciplinary construction of an agent-based model of migration, presents a choice-based interactive fiction game in which players make migration decisions to advance through a story. Participants (N = 1000 Prolific users) took part in one of four experimental conditions, three involving different renditions of the game attempting to create immersion, with the last condition presenting the decisions in standard survey format. Results Although addressing the lack of ecological validity in survey data is important for improving agent-based modelling methodology, the experimental design used to tackle this issue, while responding directly to modelling needs, proved too complex. The created experimental conditions ended up too distinct from each other, involving stimuli that differed in quantity and content. This introduced several unintended and uncontrolled confounds, making it impossible to meaningfully interpret the results of this experiment on its own. Our results act as a cautionary tale for agent-based modellers, highlighting that the modelling needs should not override the principles of experimental design, and provide motivation for more rigorous research on this topic.

Background Two-wheeled vehicles are the major mode of transportation in India. Such vehicles are exposed to excessive vibration on the road when compared to four-wheeled vehicles. However, the research on the reduction of whole body vibration in the case of two-wheelers is not explored in detail. The present study predicts rider comfort in the case of an electric two-wheeler as per ISO 2631-1, by obtaining the finding the weighted acceleration at the strategic locations of vibration at the test rig. Methods An electric two-wheeler test rig is used in the study. The values of acceleration from the test rig in running conditions are obtained by using NI LabVIEW 2019. The drive cycle of the electric vehicle (EV) test rig is controlled by Sync sols’ EV lab software. Obtaining the weighted root mean square (RMS) acceleration from running the test setup, it is compared with the ISO 2631-1 standard to obtain the rider comfort. Results Loading area, traction motor, base mount, and suspension were found to be the strategic points of vibration. Frequency weighted RMS acceleration of 0.3 to 0.4 m/s2 obtained at these points are prone to cause discomfort for the rider. Vehicle speed, road profile, and duration of exposure were found to be important parameters affecting the rider’s comfort. A maximum of 4.6 m/s2 amplitude was observed. The loading area, which corresponds to a rider’s seat in actual vehicle, is important and reduction of these vibrations make the ride comfortable for the rider. Suspension and base mount of the test rig are found to be uncomfortable observing the weighted RMS acceleration. Conclusions A suitable damping technique design is very much essential in reducing these vibrations and improve the rider comfort, as many more non-deterministic vibrations are prone to cause dis-comfort in case of actual on road riding conditions.

Background Low back pain (LBP), the primary cause of disability, is the most common musculoskeletal disorder globally and the primary cause of disability. Magnetic resonance imaging (MRI) studies are inconclusive and less sensitive for identifying and classifying patients with LBP. Hence, this study aimed to investigate the role of artificial intelligence (AI) models in the prediction of LBP using T2 weighted MRI image of the lumbar spine. Methods This was a prospective case-control study. A total of 200 MRI patients (100 cases and controls each) referred for lumbar spine and whole spine screening were included. The scans were performed using 3.0 Tesla MRI (United Imaging Healthcare). T2 weighted images of the lumbar spine were segmented to extract radiomic features. Machine learning (ML) models, such as random forest, decision tree, logistic regression, K-nearest neighbors, adaboost, and deep learning methods (DL), such as ResNet and GoogleNet, were used, and performance measures were calculated. Results Our study showed that Random forest and AdaBoost are the most reliable ML models for predicting LBP. Random forest showed high performance with area under curve (AUC) values from 0.83 to 0.88 across all lumbar vertebrae and L2-L3, L3-L4, and L4-L5 intervertebral discs (IVDs), with AUCs of 0.88 the highest at L5-S1 IVD (0.92). Adaboost demonstrated high performance at the L2-L5 vertebrae with AUC values of 0.82 to 0.90, with the highest AUC (0.97) at the L5-S1 IVD. Among the DL models, GoogleNet outperformed the other models at 30 epochs with an accuracy of 0.85, followed by ResNet 18 (30 epochs) with an accuracy of 0.84. Conclusion The study demonstrated that ML and DL models can effectively predict LBP from MRI T2 weighted image of the lumbar spine. ML and DL models could also enhance the diagnostic accuracy of LBP, potentially leading to better patient management and outcomes.

Background Academic achievement is the result of both effort and perseverance exerted by the students. This mixed-methods study aims to investigate the factors affecting the academic achievement of pharmacy students in Syrian universities. Methods A convergent parallel mixed-methods study was utilized. In the quantitative phase, a cross-sectional study was conducted on 1008 students (773 females and 235 males) from 23 Syrian universities. A questionnaire consisting of 48 items was designed to be completed by pharmacy students using a 5-point Likert scale. In the qualitative phase, twelve questions were developed to interview thirty pharmacy students from five Syrian universities to obtain in-depth insights into the factors influencing their academic achievement. Results A significant number of students lacked effective time management skills, identified as a weakness among students. The majority of students faced challenges in maintaining a consistent study routine, averaging a score of (2.0). Motivation towards learning emerged as a crucial factor in enhancing academic performance. Lecturers in the pharmacy faculty employed traditional teaching methods (2.01), and the pharmacy curriculum was perceived as lacking modernity (1.92). Quantitative findings demonstrated that pharmacy students experienced exam-related anxiety (2.05), identified as a weakness in the qualitative phase. Factors associated with the Syrian crisis, like unreliable electricity (1.87) and transportation issues (1.83), could have an impact on academic achievement. Economic conditions were identified as challenging to students’ academic performance, negatively affecting the learning process (1.98). Conclusion The results of the study demonstrate that personal factors, lecturers, educational environment, exams, and the Syrian crisis influence the academic achievement of pharmacy students in Syrian universities.

Agroecology largely focusses on terrestrial agroecosystems, but it can also be applied to fish farming. Indeed, ponds are typically used for fish production in Europe, but are also important reservoirs of biodiversity. Numerous studies demonstrate that both fish production and biodiversity are strongly determined by human management. One key practice in extensive fish farming, although more rare in Europe, is to dry out ponds. They are left dry for a complete year after several years of fish production. However, the extent to which this practice affects the functioning of the ecosystem, its biodiversity and fish production remain unclear. We investigated data from 85 fish ponds in the Dombes region, France, sampled between 2007 and 2014. We related variation in key abiotic characteristics to the time since last dry out. The dataset included organic matter content in pond sediments and concentrations of inorganic nitrogen and phosphorus in the water column, and biotic components such as macrophytes cover and richness, phytoplankton concentration and richness, macroinvertebrates density, and fish yield. Our results show that drying out facilitates the mineralization of organic matter in sediments and results in higher concentrations of inorganic nitrogen in the water column. Macrophytes cover is highest during the first year after drying out, and gradually declines after at the expense of increasing phytoplankton concentration. The diversity of both is highest in the first year after drying out and declines rapidly, especially for macrophytes. Fish yield is at its maximum in the second year. Drying out fish ponds appears to be an important agroecological practice in extensive fish farming with an application every three to four years. By nutrient recycling, this practice has a positive impact on the balance between primary producers and indirectly on the whole food web during two years. It optimizes fish production and allows biodiversity conservation.

This article presents an analysis of the impact of Open Educational Resources (OER) during the COVID-19 pandemic, as well as their potential use in the post-pandemic, in Library and Information Science (LIS) higher education institutions. The research explored how OER were used and created, what were the main barriers and drivers in practice and some main lessons learned that can help to improve the quality and increase the use of OER beyond times of crisis. The research was based on fieldwork carried out in the LIS departments of the universities of Barcelona (Spain), Hildesheim (Germany), Osijek and Zagreb (Croatia) and the University of Library Studies and Information Technologies in Sofia (Bulgaria). The methodology approach was qualitative and was based on interviews with faculty and focus groups with students. Results show that faculty members were still hesitant to adopt OER since they generally did not consider them. Moreover, those who did use them did so on their own initiative and as additional resources. We discuss the different speeds of OER implementation that have been observed depending on the faculty’s prior level of knowledge, and on whether their institutions and countries are prepared to support the use of OER. The promotion of post-pandemic OER involves greater capacity building, as well as collaboration and institutional support. Students’ attitudes about the usefulness of OER focus on their availability. The large number of teachers and students who participated in the study, as well as the international scope of the study, constitute a strength in the treatment of a topic such as the use of OER where the user perspectives and LIS context have been little addressed in the literature.

Ab initio electronic structure applications are among the most widely used in High-Performance Computing (HPC), and the eigenvalue problem is often their main computational bottleneck. This article presents our initial efforts in porting these codes to a RISC-V prototype platform leveraging a wide Vector Processing Unit (VPU). Our software tester is based on a mini-app extracted from the ELPA eigensolver library. The user-space emulator Vehave and a RISC-V vector architecture implemented on an FPGA were tested. Metrics from both systems and different vectorisation strategies were extracted, ranging from the simplest and most portable one (using autovectorisation and assisting this by fusing loops in the code) to the more complex one (using intrinsics). We observed a progressive reduction in the number of vectorised instructions, executed instructions and computing cycles with the different methodologies, which will lead to a substantial speed-up in the calculations. The obtained outcomes are crucial in advancing the porting of computational materials and molecular science codes to (post)-exascale architectures using RISC-V-based technologies fully developed within the EU. Our evaluation also provides valuable feedback for hardware designers, engineers and compiler developers, making this use case pivotal for co-design efforts.

Background Entity resolution (ER) is the process of identifying and linking records that refer to the same real-world entity. ER is a fundamental challenge in data science, and a common barrier to ER research and development is that the data fields used for this fuzzy matching are personally identifiable information, such as name, address, and date of birth. The necessary restrictions on accessing and sharing these authentic data have slowed the work in developing, testing, and adopting new methods and software for ER. We recently released pseudopeople, a Python package that allows users to generate simulated datasets with configurable noise approaching the scale and complexity of the data on which large organizations and federal agencies, like the US Census Bureau regularly perform ER. With pseudopeople, researchers can develop new algorithms and software for ER of US population data without needing access to personal and confidential information. Methods We created the simulated population data available for noising with pseudopeople using our Vivarium simulation platform. Our model simulates individuals and their families, households, and employment dynamics over time, which we observe through simulated censuses, surveys, and administrative data collection systems. Results Our simulation process produced over 900 gigabytes of simulated censuses, surveys, and administrative data for pseudopeople, representing hundreds of millions of simulants. A sample simulated population of thousands of simulants is now openly available to all users of the pseudopeople package, and large-scale simulated populations of millions and hundreds of millions of simulants are also available by online request through GitHub. These simulated population data are structured for use by the pseudopeople package, which includes additional affordances to add various kinds of noise to the data to provide realistic, sharable challenges for ER researchers.

Background Routine group and save (G&S) testing is frequently performed prior to cholecystectomy, despite growing evidence that a targeted approach is safe and avoids unnecessary investigations. This retrospective cohort study explored frequency of testing in our unit, rates of peri-operative blood transfusion and pre-operative risk factors for requiring transfusion. Methods Health records of 453 consecutive adults who underwent cholecystectomy in a UK NHS trust were reviewed for blood transfusion up to 30 days post-operatively. We compared the need for transfusion against patient demographics, indication and urgency of surgery, and the number of prior emergency hospital attendances with gallstone complications. Logistic regression determined whether prior attendances with complications of gallstones independently predicted the need for transfusion. Results Peri-operative blood transfusions within 30 days of operation occurred in 1.1% of cases, with no requirement for uncrossmatched blood. Patients who received a blood transfusion tended to have higher American Society of Anesthesiologists (ASA) grades (p = 0.017), were more likely to have an underlying primary haematological malignancy (20.0% vs. 0.2%; p = 0.022) and prior emergency hospital attendances with gallstone complications (median 4 vs. 1; p < 0.001). Logistic regression showed each prior emergency attendance was associated with 4.6-fold odds of transfusion (p = 0.019). Receiver operating characteristic curve analysis showed an area under the curve of 0.92. Three or more attendances predicted need for transfusion with 60.0% sensitivity and 98.0% specificity. 74% of patients had at least one G&S sample taken pre-operatively, costing the trust approximately £3,800 per year in materials. Conclusions The findings of this study suggest that pre-operative G&S testing prior to cholecystectomy is not routinely required. Increased frequency of prior emergency hospital attendances with gallstone complications and co-morbidities associated with coagulopathies were pre-operative risk factors for post-operative blood transfusion. More selective testing could provide large financial savings for health institutions without compromising patient safety.

Background Generalized anxiety disorder (GAD) (Chittodvega) is one among many types of mental disorders explained in Ayurveda. It can be defined as a Chitta (mind) + Udvega (anxiety)= Chittodvega- Anxious status of a mind. Celastrus paniculatus also known as Jyotishmati stimulates and improves the digestive fire and metabolism at a cellular level (Jatharagni and Majja dhatwagni). It can be correlated to GAD. GAD is characterized by feelings of threat, restlessness, irritability, sleep disturbance, and tension, and symptoms such as palpitations, dry mouth, and sweating. It affects women more frequently than men and prevalence rates are high in midlife (prevalence in females over age 35: 10%) and older subjects. In modern medicine the first-line psychological and pharmaceutical treatments are selective serotonin reuptake inhibitors (SSRIs) like sertraline (SNRIs). Aim and objectives To evaluate the comparative efficacy of Jyotishmati versus sertraline in the management of Chittodvega. Methods In this randomized active controlled double blind equivalence trial a total of 70 patients will be enrolled and divided into two equal groups. Patients between 20–50 years age of either gender having symptoms of Chittodvega and a Hamilton anxiety rating (HAM-A) scale score less than 24 (i.e., mild to moderate) will be selected for the study. In Group A, sertraline capsules 25 mg for first 7 days and then dose increased to 50 mg at bedtime for next 53 days and in Group B Jyotishmati Capsules 500 mg will be given twice a day after food with water for 60 days. Result and observation The patients will be assessed on the HAM-A scale, serum cortisol and WHO Quality of Life on day 0, 30, 60 and 90 and data will be analyzed using paired and unpaired t-tests for continuous variables and chi-square tests for categorical variables to evaluate whether treatments are equivalent. Trial registration CTRI No. REF/2023/07/069880 Date – 15/09/2023

Background Every few years, juvenile Kemp’s ridley turtles (Lepidochelys kempii) are stranded on the Dutch coasts. The main population distribution of this critically endangered species primarily inhabits the Gulf of Mexico and the east coast of the United States. This study focuses on five reports from the Netherlands between 2007 and 2022, where juvenile turtles were reported to strand alive during the winter, albeit in a hypothermic state. At ambient ocean temperatures between 10°C and 13°C, Kemp’s ridley turtles begin to show an inability to actively swim and remain afloat on the ocean’s surface, a condition termed ‘cold stunning’. Understanding their transport in cold-stunned state can help improve the rehabilitation process of stranded turtles. Methods Cold-stunned turtles are back-tracked as passive, virtual particles from their stranding location using Lagrangian flow modelling. This study investigates when and where these juvenile turtles cross the threshold temperatures between 10° C and 14° C before stranding by tracking the temperature along the trajectories. Results As expected, the simulations show the transport of the cold-stunned turtles via the English Channel. More surprisingly, the analysis suggests they likely experience cold-stunning in the southern North Sea region and encounter temperatures below 10°C for only a few days to up to three weeks, and below 12°C for up to a month before stranding. Conclusions The estimate of cold-stunned drift duration of the turtles provides additional knowledge about their health status at the time of stranding. Adherence to rehabilitation protocols for Kemp’s ridley and post-release monitoring are recommended to improve their long-term survival.

The finite-volume theory has shown to be numerically efficient and stable for topology optimization of continuum elastic structures. The significant features of this numerical technique are the local satisfaction of equilibrium equations and the employment of compatibility conditions along edges in a surface-averaged sense. These are essential properties to adequately mitigate some numerical instabilities in the gradient version of topology optimization algorithms, such as checkerboard, mesh dependence, and local minima issues. Several computational tools have been proposed for topology optimization employing analysis domains discretized with essential features for finite-element approaches. However, this is the first contribution to offer a platform to generate optimized topologies by employing a Matlab code based on the finite-volume theory for compliance minimization problems. The Top2DFVT provides a platform to perform 2D topology optimization of structures in Matlab, from domain initialization for structured meshes to data post-processing. This contribution represents a significant advancement over earlier publications on topology optimization based on the finite-volume theory, which needed more efficient computational tools. Moreover, the Top2DFVT algorithm incorporates SIMP and RAMP material interpolation schemes alongside sensitivity and density filtering techniques, culminating in a notably enhanced optimization tool. The application of this algorithm to various illustrative cases confirms its efficacy and underscores its potential for advancing the field of structural optimization.

Background Self-harm in young people is a growing concern and reducing rates a global priority. Rates of self-harm documented in general practice have been increasing for young people in the UK in the last two decades, especially in 13–16-year-olds. General practitioners (GPs) can intervene early after self-harm but there are no effective treatments presently available. We developed the GP-led COPING intervention, in partnership with young people with lived experience and GPs, to be delivered to young people 16–25 years across two consultations. This study aims to examine the feasibility and acceptability of conducting a fully powered effectiveness trial of the COPING intervention in NHS general practice. Methods This will be a mixed-methods external non-randomised before-after single arm feasibility study in NHS general practices in the West Midlands, England. Patients aged 16–25 years who have self-harmed in the last 12 months will be eligible to receive COPING. Feasibility outcomes will be recruitment rates, intervention delivery, retention rates, and completion of follow-up outcome measures. All participants will receive COPING with a target sample of 31 with final follow-up data collection at six months from baseline. Clinical data such as self-harm repetition will be collected. A nested qualitative study and national survey of GPs will explore COPING acceptability, deliverability, implementation, and likelihood of contamination. Discussion Brief GP-led interventions for young people after self-harm are needed to address national guideline and policy recommendations. This study of the COPING intervention will assess whether a main trial is feasible. Registration ISRCTN (ISRCTN16572400; 28.11.2023).

Background This study sought to document and understand facilitators and barriers to producing, translating, and using modeled evidence in decision-making in Burkina Faso, Nigeria, India, and Kenya. We explored researcher-decision-maker engagement mechanisms as key facilitators of evidence use, with a focus on knowledge brokers and boundary organizations. Methods The study used sequential mixed methods drawing on data collected from surveys and key informant interviews, complemented by a rapid desk review to map modeling activities and actors. The survey was conducted online while the qualitative research entailed in-depth interviews with modelers, knowledge brokers, and decision-makers working in a representative variety of health fields, organizations, and levels of government. This study was approved by Health Media Lab IRB (Institutional Review Board) in the United States and a local IRB in each study country and conducted between September 2021 and June 2022. Results Informants interviewed for this study described a range of factors that facilitate and inhibit the use of modeled evidence in public health decision-making at the individual, organizational, and environmental levels. Key themes included the capacity to produce, translate, and use modeled evidence; the timing and relevance of modeling outputs; the existence of communications channels between modelers and decision-makers; the strength of underlying data systems; the role of sustained funding; and the impact of global crises. Conclusion This study highlights the importance of taking an ecosystem approach to supporting modeling activities, considering individual, organizational, and environmental factors and how different actors and interact to inform the production, translation, and use of modeled evidence. Structured interaction that promotes dialogue, debate, and joint sense making between the producers and users of evidence is critical to informing and influencing the use of evidence in decision-making.

Background Major depression (MD) is a prevalent and disabling condition in Chile, with most cases being treated at the primary care level. In Chilean primary care, the authors have identified key factors associated with more complex presentations of MD and a poorer prognosis, such as a history of childhood trauma, suicidality, and comorbidities. These findings underscore the need for a multidimensional, trauma-informed, and interprofessional approach to the treatment of depression. Methods This protocol is a two-arm, single-blinded, cluster RCT to compare the effectiveness of a collaborative multidimensional approach for depression (CMAD) versus usual care to treat MD in primary care clinics in Chile. In total, 394 depressed adults from 18 to 65 years of age in twelve clinics located in Chile’s Maule Region will be consented to participate in the study. Patients and care teams from each clinic will be randomized to the intervention or to the control arm. Interprofessional teams in the intervention arm will attend 27 hours of didactic and active learning sessions focused on clinical competences to effectively engage, treat and follow up patients with the factors associated to the complex presentation of MD. Team in the control arm will receive 27 didactic sessions on current clinical guidelines for MD. Patients of both arms will be blindly assessed at baseline, three months, and six months. The primary outcome will be the reduction in depressive symptoms, with secondary outcomes including improvements in anxiety symptoms, interpersonal and social functioning, and treatment adherence. Discussion This protocol proposes the evaluation of an intervention designed to improve depression symptoms by enhancing the clinical competencies of primary care teams. These competencies are structured around collaborative care and trauma-informed practices. Trial registration NCT05016388, registered on 16 August 2021 at ClinicalTrials.gov.

Many studies report the importance of using feces as source sample for detecting SARS-CoV-2 in patients with COVID-19 symptoms but who are negative to oropharyngeal/ nasopharyngeal tests. Here, we report the case of an asymptomatic child whose family members had negative results with the rapid antigen nasopharyngeal swab tests. The 21-month-old child presented with fever, diarrhea, bilateral conjunctivitis, and conspicuous lacrimation. In this study, analysis for the presence of SARS-CoV-2 in fecal samples by using Luminex technology allowed accurate detection of the presence of the viral RNA in the feces of the child and of all her relatives, which thus resulted to be positive but asymptomatic. It is the first time that SARS-CoV-2- is observed inside the bacteria of the human gut microbiome and outside a matrix resembling extracellular bacterial lysates, in agreement with a bacteriophage mechanism with the images obtained by transmission electron microscopy (TEM), post-embedding immunogold, and by fluorescence microscope. In addition to the typical observations of respiratory symptoms, accurate evaluation of clinical gastrointestinal and neurological symptoms, combined with efficient highly sensitive molecular testing on feces, represent an efficient approach for detecting SARS-CoV-2, and for providing the correct therapy in challenging COVID-19 cases, like the one here reported.

Background Exposure to second hand smoke (SHS) is a cause for heart disease and lung cancer among non- smokers. This cluster randomized control trial will evaluate the effectiveness of a tobacco smoke free home intervention in reducing exposure to second hand smoke. Protocol The intervention will be conducted among 30 clusters in urban and peri-urban areas of Kochi, India. The sample size is 300 per arm and 15 clusters to detect a minimal difference of 0.03ng/ml in cotinine levels between groups, at 80% power with a two-sided alfa of 0.05 considering variable cluster size. A baseline survey will be undertaken to identify smokers. Data related to smoking, indoor smoking, nicotine dependence, blood pressure (BP) of smokers, morbidity experienced, and lung volume Fev1/Fev6 of smokers will be measured. Urine cotinine, morbidity, BP of spouse and child will be assessed. Air quality monitors measuring PM2.5 will be placed in homes. Trained self-help group women and frontline health workers will implement the intervention. The intervention will consist of monthly home visits to educate the smoker on the harms of second-hand smoke using 3 A’s. The circle of influencers around the smoking men will also be contacted by the members of self-help group to provide support to stop smoking within homes and to quit. They will then organize two-three meetings of community leaders and heads of women’s groups, present data on harms of SHS, and explain the rationale for establishing smoke free homes in their community for a duration of six months. After the intervention a post assessment will be conducted and this will be repeated after six months. Ethics and dissemination The trial protocol was approved by the Institutional Ethical Committee of Amrita Institute of Medical Sciences. Results will be submitted to open access peer reviewed journals and shared with other stakeholders. Trial registration CTRI/2021/06/034478

Abstract Background Moldova strives for universal health coverage (UHC) and considers health technology assessment (HTA) an important policy instrument to inform the choice of services that should be covered to progressively realize UHC. It plays a key role in determining which technologies are coved, considering various dimensions often including cost-effectiveness, budget impact, and feasibility. This paper reports on work undertaken to develop a roadmap for HTA implementation, using evidence-informed deliberative processes (EDPs) as the guiding framework. Methods Between 2020 and 2022, we undertook several activities that informed the roadmap. We conducted a needs assessment and an assessment of European HTA best practices using a combination of desk research, interviews and surveys. We then conducted a document review of six selected HTA systems, complimented by expert interviews from three neighbouring countries. Results The roadmap provided a suggested HTA process, which included instructions on how to execute the different steps of the EDP framework to enhance the legitimacy of HTA-informed decision-making. The roadmap encompasses several aspects such as how to organize stakeholder involvement, how to identify and operationalize decision criteria, and how to make the decision process transparent. Guidance was given to the country on establishing a legal framework for HTA; a communication strategy; strengthening capacity and leveraging HTA expertise. The country was also given tailored advice on the positioning of the HTA-agency, first as an entity within the Ministry of Health or the National Agency of Public Health but with the long-term vision for it to be independent of any state institution. Conclusions Despite several challenges, including a partial disruption because of the Covid-19 pandemic, the development of the roadmap for HTA implementation was completed and agreed upon by the Ministry of Health in Moldova. This work has helped motivate and support the country in HTA institutionalization.

Past research aimed at service recovery has focused on actions that are taken to retain customers, and the possibility of overcoming the mistakes of service delivery, though the multidimensional nature of the service recovery process has begun to move beyond the complaint handling process. In this paper, we identify the most important issues addressed in service recovery and present a framework for addressing them. We used an extensive integrative review methodology. Between 1988 and 2017 the number of articles in these journals was kept between 26 and 30. The majority took a business perspective to study services recovery, while a minority took an inter-disciplinarity perspective. The study’s findings are expected to provide insights into the antecedents and consequences of service recovery performance, particularly how job resources and demands influence employee burnout and work engagement, which in turn affect service recovery performance and customer perceptions of justice. The research aims to contribute to the discourse on service recovery by building a multi-level model that explains the service recovery performance of frontline employees and the impact of the service recovery system on customer justice perceptions. Thus, this research is expected to contribute to robust conclusions on the antecedents and consequences of employee service recovery performance nested within the unit-level construct, i.e., the service recovery system.

Background: Type 2 diabetes mellitus (T2DM) and its consequences are a serious global public health issue. By 2030, the number of people with type 2 diabetes is predicted to reach 439 million. The purpose of this study is to evaluate the plasma levels of glucose, HbA1c, insulin, and lipid profile in Sudanese T2DM patients. Methods: This case control study included 165 Sudanese patients with diabetic type 2 and a cardiovascular condition as cases and 165 diabetic type 2 volunteers without a cardiovascular disorder as controls. The concentrations of plasma glucose, HbA1c, and lipid profile were assessed using a Mindray BS-480 auto-chemistry analyzer, and insulin was analyzed using a Cobase 411 auto analyzer. The collected data were analyzed using statistical tools for social science computer programs (SPSS version 21). Results: According to the findings, (59.4%) of patients between the ages of (50-69). Females made up 50.9%. (38.2%) of patients had an illness duration of between (8-15 years). (41.8%) of individuals did not have hypertension. There was a substantial rise in BMI, FBG, HbA1c, HDL-C, and insulin among diabetics with cardiovascular disease compared to diabetics without cardiovascular disease (p-value = 0.001, 0.000, 0.018, and 0.000). Females had significantly higher blood TC, LDL-C, HDL-C, and BMI than males (p-values = 0.000, 0,001, and 0.000, respectively). There were significant positive correlation between FBS, HBA1c, insulin and duration of disease (r=0.155, p, value=0.005) (r=0.160, p, value=0.004)(r=0.103, p. value=0.061)respectively, while there were significant negative correlation between TC, TG,LDL-C, HDL-C and duration of disease (r=-0.152, p, value= 0.006)(r=-0.023, p, value=0.678)(r=-0.113, p, value= 0.040)(r=-0.145, p, value=0.008)respectively. Conclusion: When comparing diabetics with cardiovascular disease to diabetics without cardiovascular disease, there was a substantial rise in BMI, FBG, HbA1c, HDL-C, and insulin. FBS, HBA1c, insulin, and illness duration all had a strong positive connection.

We report an uncommon clinical presentation of a placental site trophoblastic tumor. The patient presented initially with abdominal pain with, fever, bleeding and pelvic mass on ultrasonography leading to the wrong diagnosis of a pelvic abscess. Dilation and curettage were performed and pathological examination confirmed the diagnosis of placental site trophoblastic tumor. Therefore, she underwent abdominal hysterectomy. Four years after surgery, the patient is still disease free. Gestational trophoblastic diseases should be considered in every patient presenting abnormal uterine bleeding after delivery or pregnancy loss despite the associated symptoms being very unusual.

European railway borders are facing a particular exposure to security threats and need a delicate balance between securitization and free movement, especially amid globalisation, the current geopolitical landscape and increased migrant flows. For example, the war in Ukraine illustrated the challenges experienced at the Eastern EU borders by the refugee migration surge in early 2022. This exploratory focuses on the European border security control process from the rail border perspective. It encompasses a descriptive synthesis of the lessons learned from the UIC Refugee Task Force as well as insights from the ongoing EU-funded Horizon Europe project ODYSSEUS (Unobtrusive Technologies for Secure and Seamless Border Crossing for Travel Facilitation). Project ODYSSEUS aims to support the security and integrity of the European space, reduce illegal movements of people and goods across EU borders, facilitate travelling for citizens all while protecting fundamental rights of travellers. The project will test a combination of multi-behavioural and General Data Protection Regulation (GDPR) compliant biometric user identity verification tools, allowing, when possible, citizens to cross EU border without any interruption or queue. Further, novel luggage and baggage checks will allow citizens’ vehicles and cargos to be remotely checked at land borders to speed up the border check processes in a secure and reliable manner. The project will run three pilot tests at road, rail and water borders. In this paper, we analyse the implementation of project’s technologies in the rail border crossing pilot test and discuss the implications for the actors involved in the process of railway border crossing (e.g., border authorities, railway operators and railway travellers).

Introduction Diarrhea is a significant health problem in the Third World. Identification of the pathogen that causes diarrhea is vital for measures to prevent and control this disease. There are also very few reports of diarrhea in Sudan. Our study aimed to determine the Prevalence of specific protozoan pathogens (Entamoeba histolytica, Cryptosporidium parvum., and Giardia spp) in children in Khartoum, Sudan. Methods We conducted a cross-sectional survey among children under five years of age hospitalized with acute diarrhea between April and December 2014. Diarrheal stool samples were collected, and E. histolytica, C. parvum, and Giardia spp were examined using multiplex real-time PCR. Results Four hundred and thirty-seven children with acute diarrhea were included in this study; the higher prevalence of diarrhea was in the age ≤ 2 years old (403, 92.2%), >2–≤4 years (32, 7.3%), and >4–

Background Nile tilapia (Oreochromis niloticus) is predominant cultured species in aquaculture. However, there is a scarcity of literature regarding relationship between guava and star gooseberry leaf extract and the condition factor. Thus, the present study aims to investigate the effect of guava and star gooseberry leaf extract-supplemented diets on the specific growth rate, length-weight relationship, and condition factor of Nile tilapia. Methods Six hundred and thirty Nile tilapia (8.7±0.4 g) were randomly distributed among twenty-one tanks (30 fish per tank) within a recirculation system. Over a 60-day period, the fish were fed diets supplemented with 5g/Kg and 10g/Kg of guava leaf extract (GLE-5, GLE-10), star gooseberry leaf extract (SGLE-5, SGLE-10), and a mixture of both (MxLE-5, MXLE-10). Subsequently, specific growth rate, length-weight relationship, and condition factor were determined. Results After 60 days, the specific growth rate was significantly higher in all the GLE, SGLE, and MxLE groups compared to the control group. The final lengths and weights differed significantly both in the control group and all the GLE, SGLE, and MxLE groups. The analysis of the regression equation indicated a positive correlation (r = 0.970, 0.977, 0.976, 0.974, 0.974, 0.974, and 0.969) between the length and weight of Nile tilapia in the control group and in all the GLE, SGLE, and MxLE groups. The regression exponent “b” values in all the GLE, SGLE, and MxLE groups were >3, indicating a positive allometric growth pattern in Nile tilapia compared to the control (b=2.866), which exhibited a negative allometry. The final condition factor values did not differ significantly in either the control group or any of the plant extract groups. Conclusions Nile tilapia exhibited positive allometric growth patterns and maintained good health when fed with GLE, SGLE, and MxLE groups. Therefore, these plant extracts demonstrate suitability for commercial Nile tilapia production.

Background The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) is designed to facilitate meaningful discussions between healthcare professionals, patients, and their family about preferences for treatment in future medical emergencies. People with a learning disability may face particular barriers in completing health care plans and receiving emergency treatment, however little is known about their preferences towards emergency care treatment planning. This study explores the views of people with a learning disability, and family carers about ReSPECT. Methods A reference group of 5 people with a learning disability contributed to the design of the workshops and evaluation of outputs. Online, arts-based interactive workshops were held with 2 groups of 6 people with a learning disability to explore how they felt about emergency care treatment planning, and to co-produce materials to support ReSPECT conversations. Carers of people with a learning disability participated in focus groups or interviews. Data from workshops, focus groups and interviews were analysed thematically. Results Themes were; Getting the Process Right, Lack of trust a barrier to ReSPECT planning, and Person-Centred Care. All groups supported the ReSPECT process feeling that ReSPECT plans could support person-centred care, enhancing the autonomy of a person with a learning disability and supporting the advocacy of carers. However, drawing on their previous experiences of the health care system some expressed doubt that their wishes would be carried out. Suggestions were made for improving the ReSPECT process and used to develop resources to support ReSPECT planning. Conclusions Emergency care planning and ReSPECT are viewed positively by people with a learning disability and family carers. To ensure this works well for people with a learning disability attention should be given to reasonable, personalised adjustments to support their participation in planning conversations. There is a wider challenge of fostering trust in the health care system.

Background Scientific publications have been growing exponentially, contributing to an oversaturated information environment. Quantifying a research output’s impact and reach cannot be solely measured by traditional metrics like citation counts as these have a lag time and are largely focused on an academic audience. There is increasing recognition to consider ‘alternative metrics’ or altmetrics to measure more immediate and broader impacts of research. Better understanding of altmetrics can help researchers better navigate evolving information environments and changing appetites for different types of research. Objectives Our study aims to: 1) analyse the amount and medium of Altmetric coverage of health research produced by Irish organisations (2017 – 2023), identifying changes over time and 2) investigate differences in the amount of coverage between clinical areas (e.g., nutrition vs. neurology). Methods Using Altmetric institutional access, we will gather data on research outputs published 1 January 2017 through 31 December 2023 from active Irish organisations with Research Organisation Registry (ROR) IDs. Outputs will be deduplicated and stratified by their Australian and New Zealand Standard Research Classification relating to ≥1 field of health research: Biological Sciences, Biomedical and Clinical Sciences, Chemical Sciences, Health Sciences, and Psychology. We will clean data using R and perform descriptive analyses, establishing counts and frequencies of coverage by clinical area and medium (e.g., traditional news, X, etc.); data will be plotted on a yearly and quarterly basis where appropriate. Results and Conclusions Improved understanding of one’s information environment can help researchers better navigate their local landscapes and identify pathways for more effective communication to the public. All R code will be made available open-source, allowing researchers to adapt it to evaluate their local landscapes.

Yeasts are widely known for their application in food production, but also because of their clinical significance. As human pathogens, several species of yeasts, mainly of the genus Candida and other closely related genera, are responsible for a great number of life-threatening infections. The occurrence of yeasts in cheeses, including pathogenic species, has been largely studied, yet the antifungal susceptibility of these microorganisms is rarely reported. Here, we identified the species and determined the antifungal susceptibility profile of 45 yeast Candida isolates recovered from artisanal cheeses from 20 cities in Boyacá, Colombia. Among the species, Pichia fermentans (28.9%) prevailed, followed by Pichia kudriavzevii (24.4%), Kluyveromyces marxianus (22.2%), Clavispora lusitaniae (11.1%), Candida inconspicua (6.7%) Candida parapsilosis (4.4%) and Meyerozyma guillermondii (2.2%). Notably, all seven species have been globally reported, to a greater or lesser extent, to cause fungemia and other invasive infections with high mortality rates. Remarkably, together with the intrinsically resistant P. kudriavzevii, most isolates of P. fermentans, C. inconspicua and C. parapsilosis were resistant to fluconazole, one of the most common drugs to treat candidiasis. Our findings highlight the importance of exploring the ecological niches of pathogenic yeasts, together with their antifungal susceptibility, considering that the emergence of resistance in non-commensal opportunistic pathogens poses a serious threat to public health.

Harmful algal blooms (HABs) are a significant threat to freshwater ecosystems, and monitoring for changes in biomass is therefore important. Fluorescence in-situ sensors enable rapid and high frequency real-time data collection and have been widely used to determine chlorophyll-a (Chla) concentrations that are used as an indicator of the total algal biomass. However, conversion of fluorescence to equivalent Chla concentrations is often complicated due to biofouling, phytoplankton composition and the type of equipment used. Here, we validated measurements from 24 Chla and 12 phycocyanin (cyanobacteria indicator) fluorescence in-situ sensors (Cyclops-7F, Turner Designs) against spectrophotometrically (in-vitro) determined Chla and tested a data-cleaning procedure for eliminating data errors and impacts of non-photochemical quenching. The test was done across a range of freshwater plankton communities in 24 mesocosms (i.e. experimental tanks) with a 2x3 (high and low nutrient x ambient, IPCC-A2 and IPCC-A2+50% temperature scenarios) factorial design. For most mesocosms (tanks), we found accurate (r2 ≥ 0.7) calibration of in-situ Chla fluorescence data using simple linear regression. An exception was tanks with high in-situ phycocyanin fluorescence, for which multiple regressions were employed, which increased the explained variance by >16%. Another exception was the low Chla concentration tanks (r2 < 0.3). Our results also show that the high frequency in-situ fluorescence data recorded the timing of sudden Chla variations, while less frequent in-vitro sampling sometimes missed these or, when recorded, the duration of changes was inaccurately determined. Fluorescence in-situ sensors are particularly useful to detect and quantify sudden phytoplankton biomass variations through high frequency measurements, especially when using appropriate data-cleaning methods and accounting for factors that can impact the fluorescence readings. Nevertheless, corroborating these data with in-vitro Chla assessments would provide additional validation for the early warnings provided by sensor data.

Maternal immunization is a critical strategy to prevent both maternal and infant morbidity and mortality from several infectious diseases. When the first COVID-19 vaccines became available during the pandemic, there was mixed messaging and confusion amongst the broader public and among those associated with health care systems about the recommendations for COVID-19 vaccinations in pregnancy in many countries. A multi-country, mixed-methods study is being undertaken to describe how vaccine decision-making occurs amongst pregnant and postpartum women, with a focus on COVID-19 vaccines. The study is being conducted in Brazil, Ghana, Kenya, and Pakistan. In each country, participants are being recruited from either 2 or 3 maternity hospitals and/or clinics that represent a diverse population in terms of socio-economic and urban/rural status. Data collection includes cross-sectional surveys in pregnant women and semi-structured in-depth interviews with both pregnant and postpartum women. The instruments were designed to identify attitudinal, behavioral, and social correlates of vaccine uptake during and after pregnancy, including the decision-making process related to COVID-19 vaccines, and constructs such as risk perception, self-efficacy, vaccine intentions, and social norms. The aim is to recruit 400 participants for the survey and 50 for the interviews in each country. Qualitative data will be analyzed using a grounded theory approach. Quantitative data will be analyzed using descriptive statistics, latent variable analysis, and prediction modelling. Both the quantitative and qualitative data will be used to explore differences in attitudes and behaviors around maternal immunization across pregnancy trimesters and the postpartum period among and within countries. Each country has planned dissemination activities to share the study findings with relevant stakeholders in the communities from which the data is collected and to conduct country-specific secondary analyses.

Background The nominal group technique (NGT) allows stakeholders to directly generate items for needs assessment. The objective was to demonstrate the use of NGT to inform the development of a healthcare app in patients with relapsed myeloma. Healthcare professionals with experience in the care of patients with relapsed/refractory myeloma were invited to participate. Methods One NGT group was conducted. In the group, health care professionals working in haematology were asked to vote anonymously in order of highest priority, on symptoms previously highlighted by relapsed/refractory myeloma patients in four focus groups. Results A total of 18 healthcare professionals working in the area of haematology participated in the NGT discussion; consultants (n=6), haematology registrars (n=2), specialist nurses [Advanced Nurse Practitioner/Clinical Nurse Specialist] (haematology) (n=3), staff nurse (n=1), and “other” health care professionals (n=6). Participants ranged in experience of working with myeloma patients from 2 years to over 27 years. The symptoms voted in highest priority were: Pain, Fatigue, Peripheral Neuropathy, Infection Risk and Steroid Induced Side Effects. Conclusions The NGT was an efficient method for obtaining information to inform a healthcare app.

The COST EU-PoTaRCh Action establishes a network focused on the past, present, and future significance, production, and use of major forest by-products in Europe and beyond. The Action centers around forest by-products—primarily potash, tar, resin, and charcoal (PoTaRCh), along with plant extracts—which have been produced and utilized for over 100,000 years due to their unique chemical, biological, and therapeutic properties. The primary goal of the Action is to demonstrate the importance of these products for the socio-economic development of European countries and beyond, as well as their impact on biodiversity and the natural environment. The Action's objectives are organized into five Working Groups (WGs), each aligned with specific areas of interest: heritage, chemical characterization, archaeology, environmental history, and future perspectives of PoTaRCh materials. A key aspect of the Action is its support for stakeholders outside the scientific community who possess knowledge of PoTaRCh products through their use in industries such as production, education, and the promotion of forests' natural and cultural heritage. In doing so, the Action brings together stakeholders with diverse activity profiles, including museums, state forests, the forestry industry, associations dedicated to preserving traditions, and the tourism sector. The EU-PoTaRCh Action adheres to the three key principles of COST’s inclusiveness policy: participation of inclusiveness target countries, gender balance, and the involvement of young researchers, including in leadership positions.

Background Energy communities and local electricity markets (e.g., as peer-to-peer trading) are on the rise due to increasingly decentralized electricity generation and favorable adjustment of the legal framework in many European countries. Methods This work applies a bi-level optimization model for dynamic participation in peer-to-peer electricity trading to determine the optimal parameters of new participants who want to join an energy community, based on the preferences of the members of the original community (e.g., environmental, economic, or mixed preference). The upper-level problem chooses optimal parameters by minimizing an objective function that includes the prosumers’ cost-saving and emission-saving preferences, while the lower level problem maximizes community welfare by optimally allocating locally generated photovoltaic (PV) electricity between members according to their willingness-to-pay. The bi-level problem is solved by transforming the lower level problem by its corresponding Karush-Kuhn-Tucker (KKT) conditions. Results The results demonstrate that environment-oriented prosumers opt for a new prosumer with high PV capacities installed and low electricity demand, whereas profit-oriented prosumers prefer a new member with high demand but no PV system capacity, presenting a new source of income. Sensitivity analyses indicate that new prosumers’ willingness-to-pay has an important influence when the community must decide between two new members. Conclusions The added value of this work is that the proposed method can be seen as a basis for a selection process between a large number of potential new community members. Most important future work will include optimization of energy communities over the horizon several years.

Background Data and Safety Monitoring is integral to quality assurance of clinical trials. Although monitoring is a core legal component of regulated clinical trials, non-regulated trials are not mandated to incorporate monitoring. Consequently, the monitoring process has been underutilised and underreported in this setting. This research report outlines the development and plans for implementing a bespoke Clinical Monitoring Strategy within the ‘Rehabilitation Strategies Following Oesophagogastric and Hepatopancreaticobiliary Cancer (ReStOre II) Trial’, a non-regulated trial comparing a 12-week multidisciplinary programme of rehabilitation to standard care in a cohort of 120 cancer survivors. Methods This research note provides a detailed overview of the ReStOre II Clinical Monitoring Strategy and describes the development of the strategy pre and post awarding of the grant. The strategy consists of the establishment and implementation of a comprehensive trial governance structure, inclusive of a Trial Management Group, Trial Steering Committee Meeting, and Independent Data Monitoring Committee. In addition, external trial monitoring by the Clinical Research Facility at St James’s Hospital. Three monitoring visits will be conducted during the trial; i) site initiation visit, ii) interim monitoring visit, and iii) close our visit. Results The Clinical Monitoring Strategy has been finalised and is currently being implemented within the ReStOre II Trial. Two site initiation visits and one interim monitoring visit have been completed to date. Conclusion This research note provides a template for implementation of a Clinical Monitoring Strategy in a non-regulated clinical trial. Registration ReStOre II Trial: https://clinicaltrials.gov/ct2/show/NCT03958019

Accurately modelling the propagation of radiant intensity in aqueous environments poses significant challenges for both academia and industry, due to complex interactions like absorption, scattering, and reflection. This study aims to improve the accuracy of optical modeling in water-based systems by comparing experimental data with numerical simulation techniques, addressing the need for more reliable simulation methods in multiple applications like treatment of water and environmental monitoring.Implementation has been done by analyzing how the method compares with the discrete ordinate method, radiometry, and actinometry. The study further quantifies the effect of the photoreactor quartz tube on measured intensity for multiple wavelengths. Losses in light intensity are estimated to be 10 ± 0.5% for FX-1 265 source. In contrast, the simulation in a water medium showed an increase of up to 64% in the light intensity delivered to the central part of the tube due to internal reflections and scattering. Model predictions from ray tracing successfully compared with the Discrete Ordinate Method (DOM) and experimental data (within ± 6%), ensuring the accurate design of complex systems for water disinfection. The data from simulations is seen to tackle challenges faced in complex radiation modeling and demonstrates that the method can be utilized as a useful tool for optimization and prediction.

Background Postoperative complications are an integral part of valve surgery. Common complications include hematomas, bleeding, valve dehiscence, paravalvular leak, and acute PV thrombosis. With the available data from published articles, the rate of all valve-related complications is 0.7 to 3.5% per patient annually. [1] The pathology involved is multifactorial, often blood vessel injury leading to bleeding and hematoma. Although postoperative complications are evident, incidental diagnosis of a cardiac mass in an asymptomatic and hemodynamically stable patient postoperatively is crucial, requiring non-invasive imaging for immediate surgical action. Case presentation A woman in her 50s presented with chief complaints of worsening dyspnoea with suddenonset and chest pain. Clinical findings showed apex shifted downward and outward, wide split S2, and a mid systolic murmur radiating to the mid axillary line. Twelve-lead ECG showed LA enlargement, that aligned with X-ray findings. 2D Echocardiography revealed MVP with severe MR and a dilated LV. The patient underwent successful mitral valve replacement as per ACC/AHA class I recommendation. However, postoperative TTE showed a remarkably large mass measuring 5.6 cm*4.6 cm in the RA. Reexploration was performed, followed by mass excision. Plenty of organized clots were seen compressing the RA. TEE showed no evidence of mass. Following stabilization,the patient was discharged considering optimal INR values and prosthetic valve function assessed by echocardiography. The patient’s symptoms improved during the first follow-up. Conclusion Although postoperative cardiac complications are common, appropriate diagnosis with TTE and TEE has benefited surgeons. TEE-guided reexploration aids surgeons in decision-making and strategic approaches. Failure to diagnose such complications in asymptomatic patients can ultimately complicate the procedure. Henceforth, sonographers must be skilled in the detection and identification of unusual complications to guide redo interventions. Such an approach minimizes mortality, redo procedures, and avoids CPB hence reducing long-term prognosis and outcomes with valve replacement.